Agree with “contrived” but would like to suggest that what this type of research lacks is precisely the “speculative” (aka conjectural) quality that @Gus_Hamilton’s rich and interesting clinical theorizing/speculation (above) offers us. What ruins the credibility of research of this kind for me is its disregard for the theorizing (‘priors’, if you like) of intensivists who have grappled longitudinally with hundreds of such cases. Instead, a kind of magical thinking is indulged, wherein pure technique is supposed to automagically deliver knowledge straight out of our data.
Here, I see a similar prejudice. We believe in all kinds of ‘latent’ entities, of course, that do not present themselves directly to our senses. (Atoms, for example.) The clinical sciences fall short of more mature fields, however, in failing to subject theorized latent entities to repeated, severe probing. (In the psychological sciences, for example, we find that ‘construct validation’ has come to be understood as a one-off check that definitively validates a construct—instead of the never-ending testing of living ‘nomological networks’ envisioned e.g. by Cronbach & Meehl (1955).)